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Women ‘get half the number of heart attack treatments as men’

Women receive poorer heart attack treatment than men even
when rates of diagnosis are the same, research shows.

The clinical trial, led by researchers from the
University of Edinburgh, sought to understand the impact of using the high
sensitivity troponin blood test for heart attacks but with specific thresholds
for men and women.

This increased the number of women identified by
42% – from 3,521 to 4,991 women out of a total of 22,562 women.

This increase meant a similar proportion of men and women
were found to have a heart attack or injury to the heart muscle after going to
the emergency department with chest pain (22% of women and 21% of men).

However, despite the improvement in diagnosis, women were
about half as likely as men to receive recommended heart attack treatments.
This included coronary revascularisation in which a stent is fitted (15% versus
34%), dual antiplatelet therapy (26% versus 43%) and preventative treatments
including statins (16% versus 26%).

The improvement in diagnosis also did not lead to a
decrease in the number of women who experienced another heart attack, or died
from cardiovascular disease within a year.

Dr Ken Lee, study author at the University of Edinburgh,
said the way test results and patient history are interpreted by healthcare
professionals can be subjective, and unconscious biases may influence the
diagnosis.

“This may partly explain why, even when rates of
diagnosis are increased, women are still at a disadvantage when it comes to the
treatments they receive following a heart attack,” he explained.

The research supports previous work by the team in
Edinburgh on improving heart attack diagnosis. When people arrive at the
emergency department and are suspected of having a heart attack, they are given
a troponin blood test to diagnose the cause. Hospitals tend to use a uniform
blood test for men and women, which works by measuring troponin in the blood –
a protein released from the damaged heart following a heart attack.

However, the team found the test needs to be calibrated
differently for men and women because a lower amount of troponin is released in
women during a heart attack.

“By addressing a biological difference between men and
women, we’ve successfully improved the test to detect more women who’ve had a
heart attack. These women would otherwise be misdiagnosed,” said Lee. “It’s now
important that this blood test, with its specific measures for men and women,
is used to guide treatment and that we address these disparities in the care of
men and women with heart attack. Women everywhere should benefit from improved
heart attack diagnosis.”

Dr Sonya Babu-Narayan, the British Heart Foundation’s associate
medical director and cardiologist, said progress in diagnosis needs to
translate into better treatment and improved heart attack survival chances for
women.